Aging populations and expanding technical solutions increase the demand for health care worldwide. Developing countries are building up their health care systems and are often fighting large public health threats such as those caused by the HIV/AIDS pandemic. Health care costs are rising worldwide and patients and governments are challenged to keep financing of care sustainable as well as affordable.

Countries have made different choices in the set-up of their system with a large tradition in Anglo Saxon countries of tax financed health care and government led provision of health services vis-à-vis ‘Bismarckian’ systems based on insurance arrangements often with a larger role for private provision of health services. These systems react differently to the challenge of rising cost. ECORYS assists Ministries of Health and Finance worldwide by analyzing the (future) cost of providing health care services and proposing strategies to maintain sustainability. The crucial relationship between the Ministry of Finance and the Ministry of Health is often the core to our advice focusing on issues of budget management, predictability of funding and the efficiency of spending. In developing countries the impact and efficiency of donor contributions for health are another important area of work for ECORYS.

Insurance based systems work differently and health financing issues tend to evolve around the (costing of) a sustainable insurance package, the role of the insurer as the agent responsible for purchasing health care and incentives for providers of services to work efficiently, delivering good quality (payment mechanisms). In Eastern European and Asian countries the institutional development of health insurance - as an additional financing mechanism - is a policy area often requiring a broader scope of services including capacity building. Recently, the scope of insurance systems is being tested in low-income countries in Africa and Asia with regard to micro-insurance approaches. ECORYS is actively involved in the development of this new concept by participating in the Dutch Health Insurance Platform. The aim of the platform is to promote the effectiveness of health insurance in low and middle income countries.

Examples of our project experience can be found under the heading 'Projects' (right of this text) and in our web project database.

More information
For more information, please contact:

Arthur ten Have
Manager Social Sector Development
T +0031 (0)10 453 86 82
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Wija Oortwijn
Senior consultant
T 0031 (0)10 453 84 21
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